Joint revision surgery apparatus

ABSTRACT

The present application is directed a Joint Revision Surgery Apparatus which includes a blade guide block which has a plurality of blade guide slots and a central cavity. The blade guide block central cavity is positioned over the trunnion end of the existing prosthesis to be removed and secured to the prothesis. Straight, curved and compound curved knife blades are guided by the blade guide slots to cut the prothesis free. The securing of the guide blade block support apparatus against the femur is accomplished by the means of a male threaded T handle screw or male threaded eyebolt threading into one of the female threaded orifices in the blade guide block frame. The guide blocks in varying sizes and configurations, straight and curved knifes blades and related accessories may be sold as a complete kit. The Joint Revision Surgery Apparatus facilitates rapid, efficient and complete removal of an existing prosthesis during joint revision surgery.

FIELD OF THE INVENTION

This application relates to a surgical apparatus used on jointreplacement revision surgery in the areas of the hip joint, shoulderjoint and knee joint. More particularly, the present application isdirected to a Joint Revision Surgery Apparatus includes a blade guideblock frame which has a plurality of blade guide slots and a centralcavity. The blade guide block central cavity is positioned over thetrunnion end of the existing prosthesis to be removed and secured to theprothesis. Straight, curved and compound curved knife blades are guidedby the blade guide slots to cut the prothesis free. The securing of theguide blade block support apparatus against the femur is accomplished bythe means of a T handle screw or eyebolt threading into one of thethreaded orifice in the blade guide block frame. The guide blocks invarying sizes and configurations, straight and curved knifes blades andrelated accessories may be sold as a complete kit. The Joint RevisionSurgery Apparatus facilitates rapid, efficient and complete removal ofan existing prosthesis during joint revision surgery.

BACKGROUND OF THE INVENTION

There is growing need to provide a new and refined method of performingdelicate surgical operations including hip, shoulder and knee revisions.The similarity in these operations is that the implants have to beinserted into a major bone in the area and when there is a problem withthem the prostheses has to be removed.

As with any other mechanical device, a total hip replacement can besubject to various forms of mechanical or biological failure. Such afailure may require a revision of the hip replacement to address thecause of failure and its consequences. A revision of a total hipreplacement sometimes requires removal of the femoral implant.

The revision hip implant is comprised of four parts that work togetherto restore the original function of the ball-and-socket joint, namely,(1) A metal hip stem that is inserted into the top of the thighbone; (2)A metal cup which holds the cup liner; (3) A cup liner which holds thefemoral head; and (4) The femoral head or ball which is attached to thetop of the hip stem and is inserted into the cup liner to form theball-and-socket joint.

The wearing down of the plastic component has an unfortunate sideeffect. The tiny plastic particles that wear off are attacked by yourbody's immune system, and this immune response also attacks the healthybone around your implant. This leads to a condition called osteolysis,in which the bone in the area around the joint implant softens as it isabsorbed by the body, thus making the implant unstable and in need ofrevision.

If the bone next to the primary implant is fractured in an accident,revision surgery may be required in order to provide a safe, stablejoint. In this case, the original implant may need to be removed, thefracture addressed and a revision joint implanted.

In a low percentage of cases, the hip may become infected after surgery.Although it may be successfully treated with antibiotics, there aresevere cases where a follow-up revision surgery may be required.

Hip revision operations are performed relatively infrequently. In theUnited States, there are approximately 18 revision hip replacementsperformed for every 100 hip replacements. The most common reasons forrevision are: (1) Repetitive (recurrent) dislocation of a hipreplacement; (2) Mechanical failure (implant wear and tear—loosening orbreakage); and (3) infection.

Numerous, innovations for Joint Revision Surgery Apparatus have beenprovided in the prior art described as follows. Even though theseinnovations may be suitable for the specific individual purposes towhich they address, they differ from the present Joint Revision SurgeryApparatus as hereinafter contrasted. The following is a summary of thoseprior art patents most relevant to the Joint Revision Surgery Apparatusat hand, as well as a description outlining the difference between thefeatures of the present application and those of the prior art.

U.S. Pat. No. 9,138,242 of Randell J. Lewis describes a femoral hip stemexplant system that has an alignment body which is attached to twolocations of a femoral bone and has several lockable collet typeadjustment features to set the shaft of a reamer or end mill exactly incoincidence with the femoral bone cavity axis. The shaft of the end millor reamer is supported by a sleeve member, which is inserted into adrill guide central aperture. The drill guide aperture is adjusted firstand locked to be in line with the femoral bone cavity. Each of thesleeve members has the same mating outer diameter, which fits into thedrill guide central aperture. Accordingly, the sleeve members can beinterchanged into the drill guide aperture With shafts of differentlysized reamers or end mills.

This patent describes a femoral hip stem explant or revision system thathas an alignment body which is attached to two locations of a femoralbone and has several lockable collet type adjustment features to set theshaft of a reamer or end mill exactly in coincidence with the femoralbone cavity axis. This patent describes a very invasive surgery toattach at two locations of a femoral bone where the Joint RevisionSurgery Apparatus works from the top of the femur only and leaves themost proximal portion in fairly good shape.

U.S. Pat. No. 6,740,092 of Alan Lombardo et al. describes IM revisiontools include reamers with depth markings or stops, animpactor-extractor with a coupling for attaching to tools which areinserted into and removed from the IM canal, a resection guide tower towhich a cutting block is attached and which includes a notch whichserves as both a witness mark and a holder for a femoral collar, areversible clean-up cutting block with a quick-connect clamp attachableto the guide tower for resecting the distal femur, a selection of spacerblocks for measuring the space between the femur to determine the sizeof the components to be installed, a multiple cut cutting guide forpreparing the femur, a set of 5 and 10 mm trial wedges, a trial stemvalgus adapter, femoral sizing indicators which include indications ofanterior/posterior offset, a stabilizer box cutting template which isattachable to the multiple cut cutting guide, and anterior/posterioroffset adapters for attaching the femoral component to the IM stem.

This patent describes IM revision tools that include reamers with depthmarkings or stops, an impactor-extractor with a coupling for attachingto tools which are inserted into and removed from the IM canal, aresection guide tower to which a cutting block is attached. This patentdescribes a number of tools for positioning and alignment where theJoint Revision Surgery Apparatus uses the trunnion and the sides of theexisting prostheses and the proximal portion of the femur for supportand alignment of the process.

U.S. Pat. No. 6,258,095 of Alan Lombardo et al. describes IM revisiontools include reamers with depth markings or stops, animpactor-extractor with a coupling for attaching to tools which areinserted into and removed from the IM canal, a resection guide tower towhich a cutting block is attached and which includes a notch whichserves as both a witness mark and a holder for a femoral or tibialcollar, a reversible clean-up cutting block with a quick-connect clampattachable to the guide tower for resecting the distal femur andseparate left and right clean-up cutting blocks for resecting theproximal tibia, a selection of spacer blocks for measuring the spacebetween the tibia and femur to determine the size of the components tobe installed, a multiple cut cutting guide for preparing the femur, aset of 5 and 10 mm trial wedges, a trial stem valgus adapter, femoralsizing indicators which include indications of anterior/posterioroffset, a stabilizer box cutting template which is attachable to themultiple cut cutting guide, and anterior/posterior offset adapters forattaching the femoral component to the IM stem. The tools according tothe invention are modular and can also be used in primary knee arthroptasty without 1M fixation. The methods of the invention provide accuratelocation of bone cuts so that the revision prosthetic is correctlyoriented relative the IM canal and the bone cuts.

This is another patent that describes a number of tools for positioningand alignment where the Joint Revision Surgery Apparatus uses thetrunnion and the sides of the existing prostheses and the proximalportion of the femur for support and alignment of the process.

US Patent Application Publication No. 2014/0371750 of Greg Klein et al.describes an apparatus for removal of a femoral implant that may includea handle portion and a cutting blade opposite the handle portion. Thecutting blade may include a cutting edge, wherein the cutting edgeincludes a non-linear shape to substantially match at least a portion ofa profile of the femoral implant to be removed.

This patent describes an apparatus for removal of a femoral implant thatmay include a handle portion and a cutting blade opposite the handleportion but does not describe the unique features of the Joint RevisionSurgery Apparatus.

U.S. Pat. No. 9,282,981 of Rebecca L. Chaney describes a number oforthopedic surgical instruments for use in a surgical procedure toprepare a patient's femur to receive an orthopedic prosthesis aredisclosed. The tools include guide tools, cutting tools, surgicalblocks, and other orthopedic surgical instruments configured to plan andguide the preparation of the patient's femur.

This patent describes a number of orthopedic surgical instruments foruse in a surgical procedure to prepare a patient's femur to receive anorthopedic prosthesis but does not describe unique features of the JointRevision Surgery Apparatus.

None of the foregoing prior art teaches or suggests the particularunique features of the Joint Revision Surgery Apparatus and thusclarifies the need for further improvements in the devices that can beused for these purposes.

In this respect, before explaining at least one embodiment of the JointRevision Surgery Apparatus detail, it is to be understood that thedesign is not limited in its application to the details of constructionand to the arrangement of the components set forth in the followingdescription or illustrated in the drawings. The Joint Revision SurgeryApparatuses disclosed herein are capable of other embodiments and ofbeing practiced and carried out in various ways. Also, it is to beunderstood that the phraseology and terminology employed herein are forthe purpose of description and should not be regarded as limiting.

SUMMARY OF THE INVENTION

The principle advantage of the of the Joint Revision Surgery Apparatusis to enable the performance of a significantly quicker, safer and moresuccessful joint revision surgery procedure.

Another advantage of using the Joint Revision Surgery Apparatus is tohave significantly less blood loss during the joint revision surgeryprocedure.

Another advantage of using the Joint Revision Surgery Apparatus is tohave much shorter operating room use times during the joint revisionsurgery procedure.

Another advantage of using the Joint Revision Surgery Apparatus is toperform joint revision surgery with less instrumentation and tools, forexample, cables and long stems during the procedure.

Another advantage of using the Joint Revision Surgery Apparatus is tohave quicker times to have full weight bearing capability after jointrevision surgery.

Another advantage of using the Joint Revision Surgery Apparatus is tohave fewer complications during and after joint revision surgery.

Another advantage of using the Joint Revision Surgery Apparatus is tohave less mortality following joint revision surgery.

Another advantage of using the Joint Revision Surgery Apparatus is tohave less morbidity following joint revision surgery.

An advantage of the first alternate embodiment of the Joint RevisionSurgery Apparatus is to have the internal elongated cavity allowing theupward movement of the existing prostheses.

Another advantage of using the first alternate embodiment of the JointRevision Surgery Apparatus is by tightening the T handle screw, theexisting prostheses can be moved upward.

Another advantage of using the first alternate embodiment of the JointRevision Surgery Apparatus is by tightening the T handle screw to liftupwardly to extract the existing prostheses.

An advantage of the second alternate embodiment of the Joint RevisionSurgery Apparatus is to have a simpler device to perform the jointrevision surgery procedure.

The Joint Revision Surgery process entails the positioning of thesupport apparatus over the trunnion end of the existing prostheseswithin its internal cavity. The wide knife blades will initially be usedto properly align the support apparatus with the side surfaces of theexisting prostheses. The securing of the support apparatus down againstthe femur end is accomplished by the means of the T handle screwthreading into the threaded orifice in of the existing prostheses.

Wide knife blades or shaped knife blades will be used to loosen bothsides of the existing prostheses while narrow blades will be used aroundthe tapered curved apertures and on the ends of the support apparatus.The distal end of one of the curved aperture has an internal curvatureto guide the tapered knife blade along the curved front edge of theexisting prostheses. The replaceable knives can be used in a pneumaticosteotome or tapped with a surgical hammer. Both the internally curvedfront edge and back edge of the existing prostheses may be flat or havea curved surface. The blades will be used with the sharp edge sectiontoward the side surfaces of the existing prostheses to keep the knivesfrom digging into or scraping the bone.

With respect to the above description then, it is to be realized thatthe optimum dimensional relationships for the parts of the JointRevision Surgery Apparatus, to include variations in size, materials,shape, form, function and manner of operation, assembly and use, aredeemed readily apparent and obvious to one skilled in the art, and allequivalent relationships to those illustrated in the drawings anddescribed in the specification are intended to be encompassed by thepresent design. Therefore, the foregoing is considered as illustrativeonly of the principles of the Joint Revision Surgery Apparatus. Further,since numerous modifications and changes will readily occur to thoseskilled in the art, it is not desired to limit the Joint RevisionSurgery Apparatus to the exact construction and operation shown anddescribed, and accordingly, all suitable modifications and equivalentsmay be resorted to, falling within the scope of this application.

While the apparatus and method has or will be described for the sake ofgrammatical fluidity with functional explanations, it is to be expresslyunderstood that the claims, unless expressly formulated under 35 USC112, or similar applicable law, are not to be construed as necessarilylimited in any way by the construction of “means” or “steps”limitations, but are to be accorded the full scope of the meaning andequivalents of the definition provided by the claims under the judicialdoctrine of equivalents, and in the case where the claims are expresslyformulated under 35 USC 112 are to be accorded full statutoryequivalents under 35 USC 112, or similar applicable law. The JointRevision Surgery Apparatus can be better visualized by turning now tothe following drawings wherein like elements are referenced by likenumerals.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and form a part ofthis specification, illustrate embodiments of the Joint Revision SurgeryApparatus and together with the description, serve to explain theprinciples of this application.

FIG. 1 depicts a cross section through the preferred embodiment of thesupport apparatus and tools used in performing the Joint RevisionSurgery.

FIG. 2 depicts a side view of the hip replacement prostheses.

FIG. 3 depicts a narrow blade knife used in the Joint Revision Surgery.

FIG. 4 depicts a tapered blade knife used in the Joint Revision Surgery.

FIG. 5 depicts a wide blade knife used in the Joint Revision Surgery.

FIG. 6 depicts a side view of the T handle screw used in securing andremoval of the existing prostheses.

FIG. 7 depicts a view of a normal hip illustrating the pelvis, and femurconnection.

FIG. 8 depicts a view of the femur separated from the pelvis with theexisting ball section removed and the plastic cup and metal shellexploded away. The existing hip prosthesis and ball are above theexisting cavity.

FIG. 9 depicts a perspective view of the femur end with the supportapparatus in place.

FIG. 10 depicts an end view of the preferred embodiment of the supportapparatus.

FIG. 11 depicts a side view cross section of the preferred embodiment ofthe support apparatus.

FIG. 12 depicts atop view of the preferred embodiment of the supportapparatus.

FIG. 13 depicts a side view of the angled blade knife.

FIG. 14 depicts a side view of the wide blade knife.

FIG. 15 depicts a top view of the first alternate embodiment of thesupport apparatus.

FIG. 16 depicts a cross section through the first alternate embodimentof the support apparatus with the T head screw attached to the existinghip prosthesis.

FIG. 17 depicts a cross section through the first alternate embodimentof the support apparatus with angled blade knife or the wide blade knifealong the sides of the existing prostheses and curved knives on theends.

FIG. 18 depicts a cross section through the first alternate embodimentof the support apparatus where the T handle screw is tightened to pullthe existing hip prosthesis up from the femur.

FIG. 19 depicts a perspective view of the second alternate embodiment ofthe support apparatus with a different configuration.

FIG. 20 depicts a perspective view of the second alternate embodiment ofthe support apparatus with a different configuration illustrating thetools used in the procedure.

FIG. 21 depicts a perspective view of the third alternate embodiment ofthe blade guide block.

FIG. 22 depicts a perspective view of the fourth alternate embodiment ofthe blade guide block.

FIG. 23 depicts a bottom view of the fourth alternate embodiment of theblade guide block.

FIG. 24 depicts a side view of the fourth alternate embodiment of theblade guide block.

FIG. 25 depicts a top view of the fourth alternate embodiment of theblade guide block.

FIG. 26 depicts a perspective view of the fourth alternate embodiment ofthe blade guide block and the attaching secondary blade guide block.

FIG. 27 depicts the bottom view of the secondary blade guide block.

FIG. 28 depicts the side view of the secondary blade guide block.

FIG. 29 depicts the top view of the secondary blade guide block.

FIG. 30 depicts a side view of the fourth alternate embodiment of theblade guide block and the attaching secondary blade guide blockconnected with a flat blade going through one of the four slots in theend.

FIG. 31 depicts a front view of the eye bolt.

FIG. 32 depicts a front view of the T handle screw.

FIG. 33 depicts a perspective view of the fifth alternate embodiment ofthe blade guide block with the adjustable insert and the adjustingmechanism raised up.

FIG. 34 depicts a perspective view of the fifth alternate embodiment ofthe blade guide block with the adjustable insert and the adjustingmechanism in position.

FIG. 35 depicts a side cut-away view of the fifth alternate embodimentof the blade guide block with the adjustable insert and the adjustingmechanism.

FIG. 36 depicts a perspective view of the sixth alternate embodiment ofthe internal tension spring blade guide ball using an internal springtensioner.

FIG. 37 depicts a side view of the sixth alternate embodiment of theexternal spring blade guide ball using an internal spring tensioner.

FIG. 38 depicts a perspective view of the sixth alternate embodiment ofthe blade guide ball using an external spring tensioner.

FIG. 39 depicts a side view of the seventh alternate embodiment of theblade guide ball using an external spring tensioner.

FIG. 40 depicts a perspective view of a two part eighth alternateembodiment of the blade guide ball with internal spring tensionersexposed.

FIG. 41 depicts perspective view of a two part eighth alternateembodiment of the blade guide ball with internal spring tensioners.

FIG. 42 depicts a side view of a prostheses attached to a cut-away thirdalternate embodiment of the blade guide block illustrating a thin curvedblade with handle in position with the eye bolt secured against theprostheses trunnion.

FIG. 43 depicts a side view of a large prosthesis.

FIG. 44 depicts a side view of a small prostheses with a trunnionadapter extended away from it.

FIG. 45 depicts a top view of the small prostheses illustrating thesemi-hexagonal shape.

FIG. 46 depicts a top view of a heavy curved blade a curved, sharp endand a metal end cap.

FIG. 47 depicts a side view of a heavy curved blade a curved sharp endand a metal end cap.

FIG. 48 depicts a top view of a thin curved blade a curved sharp end anda metal end cap.

FIG. 49 depicts a side view of a thin curved blade a curved sharppointed end and a metal end cap.

FIG. 50 depicts a top view of a straight narrow flat blade with a chiselshaped sharp end and a metal end cap.

FIG. 51 depicts a top view of a straight wide flat blade with atriangular shaped sharp end and a metal end cap.

FIG. 52 depicts a side view of a thin curved blade a sharp pointed end,a straight handle and a metal end cap.

FIG. 53 depicts side view of a thin curved blade a sharp pointed end, atwo part handle with the metal end cap enclosed.

FIG. 54 depicts a perspective view of a typical prosthesis with a twopart blade guide ball and a two part handle.

FIG. 55 depicts side view of a typical prosthesis with a two part bladeguide ball and a two part handle with the metal end cap enclosed.

FIG. 56 depicts a perspective view of the insert section of the two partblade guide ball.

FIG. 57 depicts a perspective view of the base section of the two partblade guide ball.

FIG. 58 depicts a perspective view of the two part blade guide ball.

FIG. 59 depicts a perspective view of a box style of containerillustrating a typical assortment of the prosthesis replacementequipment.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

As required, the detailed embodiments of the present Joint RevisionSurgery Apparatus 10A, 10B, 10C, 10D, 10E, 10F, 10G, 1OH, 10J aredisclosed herein, however, it is to be understood that the disclosedembodiments are merely exemplary of the design that may be embodied invarious forms. Therefore, specific functional and structural detailsdisclosed herein are not to be interpreted as limiting, but merely asbasic for the claims and as a representative basis for teaching oneskilled in the art to variously employ the present design in virtuallyany appropriately detailed structure.

FIG. 1 depicts a cross section through the preferred embodiment of thesupport apparatus 10A and tools used in performing the Joint RevisionSurgery. The process entails the positioning of the support apparatus12A over the trunnion end 14 of the existing prostheses 16 within itsinternal cavity 17. The wide knife blades 24 will initially be used toproperly align the support apparatus 12A with the side surfaces 42 ofthe existing prostheses 16. Then, securing the support apparatus 12Adown against the femur end 18 by the means of the male threaded T handlescrew 20 that threads into the female threaded orifice 22 in theexisting prostheses 16.

Wide knife blades 24 or shaped knife blades 26 will be used to loosenboth sides of the existing prostheses 16 while narrow blades 28 will beused around the tapered curved apertures 30 and 31 on the ends of thesupport apparatus 12A. The distal end of the curved aperture 31 has aninternal curvature 32 to guide the tapered knife blade 28 along thecurved front edge 34 of the existing prostheses 16. The replaceableknives can be used in a pneumatic osteotome 36 or tapped with a surgicalhammer. Both the internally curved front edge 34 and back edge 38 of theexisting prostheses 16 may be a flat or have a curved surface.

FIG. 2 depicts a side view of the hip replacement prostheses 40 with thetrunnion end 14 and the lower stem portion 44. A threaded existingorifice 46 is located on the exposed shoulder 48.

FIG. 3 depicts a narrow blade knife 28 used in the Joint RevisionSurgery. The blades will be used with the sharp edge 76 section awayfrom the side surfaces 78 of the existing prostheses 16 to keep theknives from digging into or scraping the metal.

FIG. 4 depicts a shaped blade knife 26 used in the Joint RevisionSurgery.

FIG. 5 depicts a wide blade knife 24 used in the Joint Revision Surgery,

FIG. 6 depicts a side view of the male threaded T handle screw 20 usedin securing and removal of the existing prostheses 16.

FIG. 7 depicts a view of a normal hip illustrating the pelvis 52, andfemur end 18 connection to the pelvis 52.

FIG. 8 depicts a view of the femur end 18 separated from the pelvis 52with the existing ball section 54 removed and the plastic cup 56 andmetal shell 58 exploded away. The hip replacement prosthesis 40 andreplacement ball 60 are above the existing cavity 62 in the femur end18.

FIG. 9 depicts a perspective view of the femur end 18 with the supportapparatus 12A in place. One of the wide knife blades 24 is positionedabove one of the two tapered guide slots 68 that extend to the sidesurfaces 42 of the existing prostheses 16. The male threaded T handlescrew 20 is shown above the orifice 70 in the support apparatus 12A thatextends to the existing female threaded orifice 46 in the existingprostheses 16. Two optional curved knives 72 are illustrated above thetapered curved slots 74 in the support apparatus 12A.

FIG. 10 depicts an end view of the preferred embodiment of the supportapparatus 12A illustrating the angles 80 of the tapered slots 68.

FIG. 11 depicts a side view cross section of the preferred embodiment ofthe support apparatus 12A illustrating the internal cavity 17 thetapered curved aperture 30 and the tapered curved aperture 31 with theinternal curvature 32 at the distal end. The bottom surface 82 of thesupport apparatus 12A will have an internally beveled edge 84 on itsperimeter.

FIG. 12 depicts atop view of the preferred embodiment of the supportapparatus 12A illustrating the tapered curved aperture 30 and thetapered curved aperture 31 with the internal curvature 32 at the distalend, the two tapered guide slots 68 and the orifice for the “T” handlescrew 20.

FIG. 13 depicts a side view of the angled blade flat knife 86 to be usedon the first alternate embodiment of the support apparatus 12B.

FIG. 14 depicts a side view of the wide blade knife 88 to be used on thefirst alternate embodiment of the support apparatus 12B.

FIG. 15 depicts a top view of the first alternate embodiment of thesupport apparatus 10B with support apparatus 12B having an elongatedorifice 90 at the top of the enlarged internal elongated cavity 92. Thecavity has been elongated to the back side to allow the existingprostheses 16 to only move back and up when the T head screw 20 istightened to extract the device.

FIG. 16 depicts a cross section through the first alternate embodimentof the of the support apparatus 10B with the T head screw 20 attached tothe existing prosthesis 16 and the wide blade knife 88 is inserted inone of the tapered guide slots 68 to align the support apparatus 12B inposition on the existing prosthesis 16.

FIG. 17 depicts a cross section through the first alternate embodimentof the support apparatus 10B with angled blade knife 86 or the wideblade knife 88 inserted along the sides of the existing prostheses 16and curved knives 72 on the ends.

FIG. 18 depicts a cross section through the first alternate embodimentof the support apparatus 10B where the T handle screw 20 is tightened topull the existing prosthesis 16 up from the femur end 18. If necessary,the T handle screw 20 can be partially backed out of the existingprosthesis 16 and can be moved up and down to further release theadhesive bond on the device.

FIG. 19 depicts a perspective view of the second alternate embodiment ofthe support apparatus 10C with a different simpler configuration of thesupport apparatus 12C with two tapered guide slots 68, the taperedcurved aperture 30 and tapered aperture 31 with the internal curvature32 in the distal end. A conventional style of male threaded set screw 94will be used to secure the support apparatus 10C in place over the femurend 18.

FIG. 20 depicts a perspective view of the second alternate embodiment ofthe support apparatus 10C with the different simpler configuration ofthe support apparatus 12C illustrating the tools used in the procedure.A wide blade knife 98 with a depth restricting section 100 can be usedwith the pneumatic osteotome 36 or tapped with a surgical hammer Twooptional curved blades 72 may be used in the tapered curved aperture 30and tapered aperture 31 with the internal curvature 32. Two small bladeadapters 102 and one large blade adapter 104 will fit over the top ofthe blades when they are used by hand pressure or tapped with a surgicalhammer.

FIG. 21 depicts a perspective view of the third alternate embodiment ofthe one-piece blade guide block 10D illustrating the locations of theangular blade slots 200, the smooth alignment orifice 202, the femalethreaded angled eye bolt orifice 204 and the female threaded securingorifice 206 along with the curved blade cavity 208. This one-piece guideblade block 10D could be constructed of stainless steel, compositematerials or hard plastic.

FIG. 22 depicts a perspective view of the fourth alternate embodiment ofthe two-piece blade guide block 10E illustrating the locations of theangular blade slots 200, the smooth alignment orifice 202, the femalethreaded angled eye bolt orifice 204 and the female threaded securingorifice 206 and the insert cavity 212 with the insert 214 moved away,along with the curved blade cavity 208 with the male threaded eye bolt210 raised above and the insert cavity 212. This two-piece guide bladeblock 10E could be constructed of stainless steel, composite materialsor hard plastic.

FIG. 23 depicts a bottom view of the fourth alternate embodiment of theblade guide block 10E detailing the bottom view with angular blade slots200, the smooth alignment orifice 202, the threaded angled eye boltorifice 204 and the threaded securing orifice 206 along with the curvedblade cavity 208 with the insert cavity 212 and the flat front bladeguide surface 216. The prosthesis tninnion cavity 218 does not fullypenetrate completely through the device.

FIG. 24 depicts a side view of the fourth alternate embodiment of theblade guide block 10E illustrating the flat front blade guide surface216.

FIG. 25 depicts a top view of the fourth alternate embodiment of theblade guide block 10E detailing the top view with angular blade slots200, the smooth alignment orifice 202, the female threaded angled eyebolt orifice 204 and the female threaded securing orifice 206 along withthe curved blade cavity 208 with the insert cavity 212 and the flatfront blade guide surface 216.

FIG. 26 depicts a perspective view of the fourth alternate embodiment ofthe two-piece blade guide block 10E with a secondary handle-shaped guideblock 10F, illustrating the top view with angular blade slots 200, thesmooth alignment orifice 202, the female threaded angled eye boltorifice 204 and the female threaded securing orifice 206 along with thecurved blade cavity 208 with the insert 212 cavity and the flat frontblade guide surface 216. The attaching secondary blade guide block 10Fis shown raised up illustrating the location of the locating dowel 222that mates with the smooth alignment orifice 202 and the male threadedT-screw 224 goes through the orifice 226 in the secondary blade guideblock 10F and into the female threaded securing orifice 206. The distalend 228 of the secondary blade guide block 10F is shown with four slots230 that will align with the flat front blade guide surface 216 of theblade guide block 10E for different styles of prosthesis. The dowel 232when inserted allows the insert 214 to move slightly keeping it frombinding with the different knife blades.

FIG. 27 depicts the bottom view of the secondary blade guide block 10Fshowing the four slots 230 the end of the locating dowel 222 and theorifice 226.

FIG. 28 depicts the side view of the secondary blade guide block 10Fshowing the four slots 230 the end of the locating dowel 222.

FIG. 29 depicts the top view of the secondary blade guide block 10Fshowing the four slots 230 and the orifice 226.

FIG. 30 depicts a side view of the fourth alternate embodiment of theblade guide block 10E with the attached secondary blade guide block 10Fwith the male threaded T handle screw 20 and a flat knife blade 232 withthe upper metal cap end 234 extending through one of the slots 230located in the secondary blade guide block 10F.

FIG. 31 depicts a front view of the male threaded eye bolt 210.

FIG. 32 depicts a front view of the male threaded T handle screw 20.

FIG. 33 depicts a perspective view of the fifth alternate embodiment ofthe blade guide block 10G with angular blade slots 200, the smoothalignment orifice 202, the female threaded angled eye bolt orifice 204,the threaded securing orifice 206 and the curved blade cavity 208. Theinsert 212 cavity with the adjustable insert 240 and the adjustingmechanism 242 has a pressure adjustment knob 244 shown raised up. Theadjusting mechanism 242 can be slid down through grooves 246 on eitherside of the insert cavity 212 in the blade guide block 10G to be able tomove the adjustable insert 240 forward and backward.

FIG. 34 depicts a perspective view of the fifth alternate embodiment ofthe blade guide block 10G with the adjustable insert 240 in the insertcavity 212 and the adjusting mechanism 242 in position.

FIG. 35 depicts a side cut-away view of the fifth alternate embodimentof the blade guide block 10G with the adjustable insert 240 and theadjusting mechanism 242. The pressure adjustment knob 244 is secured inplace in the adjusting mechanism 242 by the means of a snap ring 248 sothat when the pressure adjustment knob 244 is rotated the adjustableinsert 240 can move forward and backward, to be able to put a lightpressure on a blade within the curved blade cavity 208.

FIG. 36 depicts a perspective view of the sixth alternate embodiment ofthe internal tension spring blade guide ball 10H using an internalspring tensioner 254 to restrain the female guide ball section 256 tothe male guide ball section 260 that has the prosthesis trunnion orifice262 at the bottom.

FIG. 37 depicts a side view of the sixth alternate embodiment of theexternal spring blade guide ball 10H using an internal spring tensioner254 to restrain the female guide ball section 256 to the male guide ballsection 260 that has the prosthesis trunnion orifice 262 at the bottom.

FIG. 38 depicts a perspective view of the sixth alternate embodiment ofthe blade guide ball 10J using an external spring tensioner 264 torestrain the female guide ball section 256 to the male guide ballsection 260 to restrain the female guide ball section 256 to the maleguide ball section 260 that has the prosthesis trunnion orifice 262 atthe bottom.

FIG. 39 depicts a side view of the seventh alternate embodiment of theblade guide ball 10J using an external spring tensioner 264 to restrainthe female guide ball section 256 to the male guide ball section 260.

FIG. 40 depicts a perspective view of a two part eighth alternateembodiment of the blade guide ball 10K with an external elastictensioner 266 to restrain the female guide ball section 256 to the maleguide ball section 260 that has the prosthesis trunnion orifice 262 atthe bottom.

FIG. 41 depicts a side view of a two part eighth alternate embodiment ofthe blade guide ball 10K with an external elastic tensioner 266 torestrain the female guide ball section 256 to the male guide ballsection 260.

FIG. 42 depicts a side view of a large prostheses 270 attached to acut-away third alternate embodiment of the basic blade guide block 10Dillustrating a thin curved blade with straight handle 274 in thecompound curved prosthesis blade 288 and a curved handle 274 cavity 208with the male threaded eye bolt 210 secured tightly against theprostheses trunnion 272 to aide in the extraction of the prosthesis.

FIG. 43 depicts a side view of a small prosthesis 276 having thetrunnion 272 and the trunnion size adaptor 278 which fits over theprostheses trunnion 272 to add thickness to the prostheses trunnion 272for a better fit with the blade guide block used in the revision surgeryprocedure.

FIG. 44 depicts a top view of the small prostheses 276 illustrating thesemi-hexagonal shape 280 of the upper section of the small prostheses276 that conforms to the angular slots 200 in the blade guide blocks10D, 10E and 10G. Different sizes are anticipated to accommodatediffering sizes of implanted stems undergoing revision surgery.

FIG. 45 depicts a cross section through a compound curved prosthesisblade 288 where the inner surface 290 conforms to the shape of thetypical prosthesis radius and the length of the typical blade has asweeping curve to it.

FIG. 46 depicts a top view of a heavy compound curved prosthesis 288with a curved sharp end 218 and a metal end cap 234.

FIG. 47 depicts a side view of a heavy compound curved prosthesis blade288 a curved sharp end 218 and a metal end cap 234.

FIG. 48 depicts a top view of a thin compound curved prosthesis blade288 with a curved sharp pointed end 292 and a metal end cap 234.

FIG. 49 depicts a side view of a thin compound curved prosthesis blade288 with a curved sharp pointed end 292 and a metal end cap 234.

FIG. 50 depicts a top view of a straight narrow flat blade 294 with achisel shaped sharp end 296 and a metal end cap 234.

FIG. 51 depicts a top view of a straight wide flat blade 298 with atriangular shaped sharp end 300 and a metal end cap 234.

FIG. 52 depicts a side view of a thin compound curved prosthesis blade288 with a straight handle 274 and a metal end cap 234.

FIG. 53 depicts side view of a thin compound curved prosthesis blade 288with a two part handle 302 and the metal end cap 234 enclosed.

FIG. 54 depicts a perspective view of a large prosthesis 270, thecompound curved prosthesis blade 288 with a two part blade guide ball304 and a two part handle 302.

FIG. 55 depicts side view of a large prosthesis 270 the compound curvedprosthesis blade 288 with a two part blade guide ball 304 and a two parthandle 302 with the metal end cap 234 enclosed.

FIG. 56 depicts a perspective view of the female guide ball section 256of the two part blade guide ball 304 where the female guide ball section256 includes two wings on both sides of the female guide ball section256.

FIG. 57 depicts a perspective view of the male guide ball section 260 ofthe two part blade guide ball 304 where the male guide ball section 260includes two slots for accepting the wings located on both sides of thefemale guide ball section 256 (see FIG. 56).

FIG. 58 depicts a perspective view of the two part blade guide ball 304assembled together, where the female guide ball section 256 two wingslocated on both sides of the female guide ball section 256 have matedwith the two slots located on the male guide ball section 260 foraccepting the wings located on both sides of the female guide ballsection 256.

FIG. 59 depicts a perspective view of a box style of container 306illustrating a typical assortment of prosthesis removal devices. It isanticipated that these assembled kits for performing joint revisionsurgery will contain any number, style and varying sizes of blade guideblocks, blade guide balls, curved knife blades, straight knife blades,narrow knife blades, wide knife blades, knife blades with attached knifeblade handles, one-piece removable replacement knife blade handles,two-piece removeable replacement knife blade handles, eyebolts, T handlescrews, T screws and possibly even a pneumatic osteotome.

The Joint Revision Surgery Apparatus 10A, 10B, 10C, 10D, 10E, 10F, 10G,10H, 10J shown in the drawings and described in detail herein disclosearrangements of elements of particular construction and configurationfor illustrating preferred embodiments of structure and method ofoperation of the present design. It is to be understood, however, thatelements of different construction and configuration and otherarrangements thereof, other than those illustrated and described may beemployed for providing a Joint Revision Surgery Apparatus 10A, 10B, 10C,10D, 10E, 10F, 10G, 10H, 10J in accordance with the spirit of thisapplication, and such changes, alternations and modifications as wouldoccur to those skilled in the art are considered to be within the scopeof this application as broadly defined in the appended claims.

While certain embodiments, of the inventions have been described, theseembodiments have been presented by way of example only, and are notintended to limit the scope of the disclosure. Indeed, the novel methodsand systems described herein may be embodied in a variety of otherforms. Furthermore, various omissions, substitutions and changes in thesystems and methods described herein may be made without departing fromthe spirit of the disclosure. For example, one portion of one of theembodiments described herein can be substituted for another portion inanother embodiment described herein. The accompanying claims and theirequivalents are intended to cover such forms or modifications as wouldfall within the scope and spirit of the disclosure. Accordingly, thescope of the present inventions is defined only by reference to theappended claims.

Features, materials, characteristics, or groups described in conjunctionwith a particular aspect, embodiment, or example are to be understood tobe applicable to any other aspect, embodiment or example described inthis section or elsewhere in this specification unless incompatibletherewith. All of the features disclosed, in this specification(including any accompanying claims, abstract and drawings), and/or allof the steps of any method or process so disclosed, may be combined inany combination, except combinations where at least some of suchfeatures and/or steps are mutually exclusive. The protection is notrestricted to the details of any foregoing embodiments. The protectionextends to any novel one, or any novel combination, of the featuresdisclosed in this specification (including any accompanying claims,abstract and drawings), or to any novel one, or any novel combination,of the steps of any method or process so disclosed.

Furthermore, certain features that are described in this disclosure inthe context of separate implementations can also be implemented incombination in a single implementation. Conversely, various featuresthat are described in the context of a single implementation can also beimplemented in multiple implementations separately or in any suitablesubcombination. Moreover, although features may be described above asacting in certain combinations, one or more features from a claimedcombination can, in some cases, be excised from the combination, and thecombination may be claimed as a subcombination or variation of asubcombination.

Moreover, while operations may be depicted in the drawings or describedin the specification in a particular order, such operations need not beperformed in the particular order shown or in sequential order, or thatall operations be performed, to achieve desirable results. Otheroperations that are not depicted or described can be incorporated in theexample methods and processes. For example, one or more additionaloperations can be performed before, after, simultaneously, or betweenany of the described operations. Further, the operations may berearranged or reordered in other implementations. Those skilled in theart will appreciate that in some embodiments, the actual steps taken inthe processes illustrated and/or disclosed may differ from those shownin the figures. Depending on the embodiment, certain of the stepsdescribed above may be removed, others may be added. Furthermore, thefeatures and attributes of the specific embodiments disclosed above maybe combined in different ways to form additional embodiments, all ofwhich fall within the scope of the present disclosure. Also, theseparation of various system components in the implementations describedabove should not be understood as requiring such separation in allimplementations, and it should be understood that the describedcomponents and systems can generally be integrated together in a singleproduct or packaged into multiple products.

For purposes of this disclosure, certain aspects, advantages, and novelfeatures are described herein. Not necessarily all such advantages maybe achieved in accordance with any particular embodiment. Thus, forexample, those skilled in the art will recognize that the disclosure maybe embodied or carried out in a manner that achieves one advantage or agroup of advantages as taught herein without necessarily achieving otheradvantages as may be taught or suggested herein.

Conditional language, such as “can,” “could,” “might,” or “may,” unlessspecifically stated otherwise, or otherwise understood within thecontext as used, is generally intended to convey that certainembodiments include, while other embodiments do not include, certainfeatures, elements, and/or steps. Thus, such conditional language is notgenerally intended to imply that features, elements, and/or steps are inany way required for one or more embodiments or that one or moreembodiments necessarily include logic for deciding, with or without userinput or prompting, whether these features, elements, and/or steps areincluded or are to be performed in any particular embodiment.

Conjunctive language such as the phrase “at least one of X, Y, and Z,”unless specifically stated otherwise, is otherwise understood with thecontext as used in general to convey that an item, term, etc. may beeither X, Y, or Z. Thus, such conjunctive language is not generallyintended to imply that certain embodiments require the presence of atleast one of X, at least one of Y, and at least one of Z.

Language of degree used herein, such as the terms “approximately,”“about,” “generally,” and “substantially” as used herein represent avalue, amount, or characteristic close to the stated value, amount, orcharacteristic that still performs a desired function or achieves adesired result. For example, the terms “approximately”, “about”,“generally,” and “substantially” may refer to an amount that is withinless than 10% of, within less than 5% of, within less than 1% of, withinless than 0.1% of, and within less than 0.01% of the stated amount. Asanother example, in certain embodiments, the terms “generally parallel”and “substantially parallel” refer to a value, amount, or characteristicthat departs from exactly parallel by less than or equal to 15 degrees,10 degrees, 5 degrees, 3 degrees, 1 degree, or 0.1 degree.

The scope of the present disclosure is not intended to be limited by thespecific disclosures of preferred embodiments in this section orelsewhere in this specification, and may be defined by claims aspresented in this section or elsewhere in this specification or aspresented in the future. The language of the claims is to be interpretedbroadly based on the language employed in the claims and not limited tothe examples described in the present specification or during theprosecution of the application, which examples are to be construed asnon-exclusive.

Further, the purpose of the foregoing abstract is to enable the U.S.Patent and Trademark Office, foreign patent offices worldwide and thepublic generally, and especially the scientists, engineers andpractitioners in the art who are not familiar with patent or legal termsor phraseology, to determine quickly from a cursory inspection thenature and essence of the technical disclosure of the application. Theabstract is neither intended to define the invention of the application,which is measured by the claims, nor is it intended to be limiting as tothe scope of the invention in any way.

I claim:
 1. A joint revision surgery apparatus comprising: (a) a bladeguide block having a solid frame including one or more orifices thereinwherein said one or more orifices further includes one or more femalethreaded orifices configured to accept male threaded screws, handles andbolts for securing said blade wide block to an existing prosthesisimplant; (b) a plurality of blade guide slots extending through saidblade guide block configured to accept the insertion of and to guide themotion of a plurality of knife blades; and (c) a centrally locatedcavity within said blade guide block configured to be placed over thetrunnion end of an existing prosthesis implant; wherein said blade guideblock is placed over the trunnion end of an existing prosthesis implantand secured within said centrally located cavity, followed by theinsertion and downward motion of a plurality of knife blades into saidknife blade slots extending through said blade guide block to free theexisting prothesis implant to facilitate removal of the existingprothesis implant during joint revision surgery.
 2. The joint revisionsurgery apparatus according to claim 1, wherein said blade guide blockhaving a solid frame includes a one-piece solid frame, and furtherwherein said one-piece solid frame varies in size depending on the sizeof the existing prothesis implant to be removed during joint revisionsurgery.
 3. The joint revision surgery apparatus according to claim 1,wherein said blade guide block having a solid frame includes a two-piecesolid frame assembly and further wherein said two-piece solid frameassembly includes an adjustable knife blade accepting orifice configuredto adjust to accept knife blades of varying thicknesses.
 4. The jointrevision surgery apparatus according to claim 1, wherein said pluralityof blade guide slots extending through said blade guide block configuredto accept the insertion of and to guide the motion of a plurality ofknife blades includes a plurality of blade guide slots configured toaccept straight knife blades.
 5. The joint revision surgery apparatusaccording to claim 1, wherein said plurality of blade guide slotsextending through said blade guide block configured to accept theinsertion of and to guide the motion of a plurality of knife bladesincludes a plurality of blade guide slots configured to accept curvedknife blades.
 6. The joint revision surgery apparatus according to claim1, wherein said plurality of blade guide slots extending through saidblade guide block configured to accept the insertion of and to guide themotion of a plurality of knife blades includes a plurality of bladeguide slots configured to accept compound curved knife blades.
 7. Thejoint revision surgery apparatus according to claim 1, wherein saidblade guide block having a solid frame including one or more femalethreaded orifices therein includes female threaded orifices configuredto accept male threaded set screws for securing said blade guide blockto an existing prosthesis implant when the trunnion end of an existingprothesis implant is placed within said centrally located cavity, andsaid male threaded set screw is tightened down.
 8. The joint revisionsurgery apparatus according to claim 1, wherein said blade guide blockhaving a solid frame including one or more female threaded orificestherein includes threaded orifices configured to accept male threaded Thandle screws for securing said blade guide block to an existingprosthesis implant when the trunnion end of an existing prothesisimplant is placed within said centrally located cavity, and said malethreaded T handle screw is tightened down.
 9. The joint revision surgeryapparatus according to claim 1, wherein said blade guide block having asolid frame including one or more female threaded orifices thereinincludes threaded orifices configured to accept male threaded eye boltsfor securing said blade guide block to an existing prosthesis implantwhen the trunnion end of an existing prothesis implant is placed withinsaid centrally located cavity, and said male threaded eye bolt istightened down.
 10. The joint revision surgery apparatus according toclaim 1, wherein said blade guide blocks are assembled into a kit to besold together, including kits which will contain any number, style andvarying sizes of blade guide blocks, blade guide balls, curved knifeblades, straight knife blades, narrow knife blades, wide knife blades,knife blades with attached knife blade handles, one-piece removablereplacement knife blade handles, two-piece removeable replacement knifeblade handles, eyebolts, T handle screws, and set screws.
 11. A methodof making a joint revision surgery apparatus comprising the steps of:(a) providing a blade guide block having a solid frame including one ormore orifices therein wherein said one or more orifices further includesone or more female threaded orifices configured to accept male threadedscrews, handles and bolts for securing said blade guide block to anexisting prosthesis implant; (b) providing a plurality of blade guideslots extending through said blade guide block configured to accept theinsertion of and to guide the motion of a plurality of knife blades; and(c) providing a centrally located cavity within said blade guide blockconfigured to be placed over the trunnion end of an existing prosthesisimplant; (d) providing curved knife blades, straight knife blades,narrow knife blades, wide knife blades, knife blades with attached knifeblade handles, one-piece removable replacement knife blade handles,two-piece removeable replacement knife blade handles; and (e) providingmale threaded eyebolts, T handle screws, and set screws configured to bethreaded into said female threaded orifices: wherein when in use saidblade guide block is placed over the trunnion end of an existingprosthesis implant and secured within said centrally located cavity,followed by the insertion and downward motion of a plurality of knifeblades into said knife blade slots extending through said blade guideblock to free the existing prothesis implant to facilitate removal ofthe existing prothesis implant during joint revision surgery.
 12. Themethod of making a joint revision surgery apparatus according to claim11, wherein said blade guide block having a solid frame includes aone-piece solid frame, and further wherein said one-piece solid framevaries in size depending on the size of the existing prothesis implantto be removed during joint revision surgery.
 13. The method of making ajoint revision surgery apparatus according to claim 11, wherein saidblade guide block having a solid frame includes a two-piece solid frameassembly and further wherein said two-piece solid frame assemblyincludes an adjustable knife blade accepting orifice configured toadjust to accept knife blades of varying thicknesses.
 14. The method ofmaking a joint revision surgery apparatus according to claim 11, whereinsaid plurality of blade guide slots extending through said blade guideblock configured to accept the insertion of and to guide the motion of aplurality of knife blades includes a plurality of blade guide slotsconfigured to accept straight knife blades.
 15. The method of making ajoint revision surgery apparatus according to claim 11, wherein saidplurality of blade guide slots extending through said blade guide blockconfigured to accept the insertion of and to guide the motion of aplurality of knife blades includes a plurality of blade guide slotsconfigured to accept curved knife blades.
 16. The method of making ajoint revision surgery apparatus according to claim 11, wherein saidplurality of blade guide slots extending through said blade guide blockconfigured to accept the insertion of and to guide the motion of aplurality of knife blades includes a plurality of blade guide slotsconfigured to accept compound curved knife blades.
 17. The method ofmaking a joint revision surgery apparatus according to claim 11, whereinsaid blade guide block having a solid frame including one or moreorifices therein further includes female threaded orifices configured toaccept male threaded set screws for securing said blade guide block toan existing prosthesis implant when the trunnion end of an existingprothesis implant is placed within said centrally located cavity, andsaid male threaded set screw is tightened down.
 18. The method of makinga joint revision surgery apparatus according to claim 11, wherein saidblade guide block having a solid frame including one or more orificestherein further includes female threaded orifices configured to acceptmale threaded T handle screws for securing said blade guide block to anexisting prosthesis implant when the trunnion end of an existingprothesis implant is placed within said centrally located cavity, andsaid male threaded set screw is tightened down.
 19. The method of makinga joint revision surgery apparatus according to claim 11, wherein saidblade guide block having a solid frame including one or more orificestherein further includes female threaded orifices configured to acceptmale threaded eye bolts for securing said blade guide block to anexisting prosthesis implant when the trunnion end of an existingprothesis implant is placed within said centrally located cavity, andsaid male threaded set screw is tightened down.
 20. The method of makinga joint revision surgery apparatus according to claim 11, wherein saidblade guide blocks are assembled into a kit to be sold together,including kits which will contain any number, style and varying sizes ofblade guide blocks, blade guide balls, curved knife blades, straightknife blades, narrow knife blades, wide knife blades, knife blades withattached knife blade handles, one-piece removable replacement knifeblade handles, two-piece removeable replacement knife blade handles,eyebolts, T handle screws, and set screws.